Diagnosis of Male Infertility using Ultrasound

Abstract This study was carried out in Khartoum Dermatology and Venereology Teaching Hospital department of andrology during March 2017 to July 2017. This study done to diagnosis of infertile male patients using ultrasonography, to study common causes of male infertility.to study sonographic appearance of normal and pathology of the scrotum ,to correlate between pathological finding and seminal analysi to correlate between patients age and testicular size,to correlate between occupation and testicular pathology and to correlate between duration of infertility and testicular pathology. Total of “60” patients, age between 20-65 years, have infertility diagnosed by semen analysis, all patients were examined by U/S scanning using E Cube ultrasound machine with high frequency linear transducer (7.5-10MHz). Result: Most of the patients had Azoospeia 38.3%. 66% of them was workers, Varicocele was the most common sonographic abnormality in this study occurring in 61.7%, hydrocele 13.3%. ,(1.7%) of patients also had epididymal thickening a possible sequel to chronic epididymoorchitis, epididymal cysts 11.7% and microlithiasis 1.7%, calcification 3.3% and testicular cyst 1.7%. There is significant correlation between testicular size and seminal analysis results 15 patients out of 60 patients diagnosed as small size testis with azoospermia and correlation between work and infertility. Conclusion: Testicular volume has a direct correlation with semen parameters. The measurement of testicular volume can be helpful for assessing fertility at the initial physical examination Also type of work with strong correlation most common pathology is varicocele.for that we recommended to do scrotal ultrasound to infertile male patients as rotine after semen analysis and hormonal profile because it reflect testicular function by measure testicular size.

List of Contents

Contents Page

I الآیة

Dedication II

Acknowledgement III

Abstract IV

V الخلاصة

List of content VI

List of Tables VII

List of Figure VIII

List of abbreviations X

CHAPTER ONE

2.1.Introduction 1

2.2.Justification: 2

2.3.Objectives: 2

2.3.1. General objectives 2

2.3.2. Specific objectives 2

CHAPTER TWO: Literature Review

2.1.Literature Review 3

2.2.Anatomy and physiology 3

2.2.1.Scrotum 3

2.2.2.Testes 4

2.2.3.Epididymis 7

2.2.4.Ductus (vas) deferens 8

2.2.5.Spermatic cord 8

2.2.6.Ejaculatory ducts 9

2.2.7.Seminal vesicles 9

2.2.8.Bulbourethral gland 10

2.2.9.Prostate 11

2.2.10.Urethra 12

2.2.11.Penis 13

2.3.Sonographic Appearance 15

2.3.1.Technique 15

2.3.2.Testis 15

2.3.3.Epididymis 16

2.4.Infertility: 17

2.4.1.Pathophysiology: 18

2.4.2.Spermatogenesis 18

2.4.3. Prevalence 19

2.4.4. Mortality/Morbidity 20

2.4.5.Causes: 20

2.4.5.1.Pretesticular causes of infertility 20

2.4.5.2.Other conditions 20

2.4.5.3.Peripheral organ 21

2.4.5.4.Primary testicular causes of infertility 21

2.4.5.5.Chromosomal abnormalities 21

CHAPTER THREE: Materials and Methods

3.1. Materials 31

3.1.1. Inclusion and Exclusion criteria 31

3.1.2.Ethical approval 31

3.1.3. Data collection 31

3.1.4.Data analysis 31

3.2. Methods: 32

3.2.1.Scrotal ultrasonography 32

Chapter Four :Results

4.1. Results 33

Chapter Five: Discussion

5.1Discussion 42

5.2Conclusion: 44

5.3 Recommendation: 44

References 45

Appendices 51